Abstract
OBJECTIVE: This study aims to explore the impact of the triglyceride-glucose (TyG) index and TyG index combined with body mass index (BMI) on risk of incident EC and to estimate the proportion of risk of incident EC mediated by BMI through the TyG index.</p>
METHODS: Using the UK Biobank cohort, we included a sample of 168,431 participants for primary analysis. The risk of incident EC was evaluated using multivariable Cox proportional-hazards models. We applied a 2-stage regression approach to investigate the mediation effects. Polygenic risk scores were derived from established single nucleotide polymorphisms associated with EC.</p>
RESULTS: The study found that a higher TyG index is associated with an increased risk of incident EC (hazard ratio [HR]=1.322; p<0.001, per 1 standard deviation [SD] increment), and subgroup analysis revealed a significant trend in the overweight and obesity subgroups (p-value for the quartile trend <0.001). The TyG-BMI index exhibited a notable association with risk of incident EC (HR=1.741; p<0.001, per 1 SD increment). Mediation analysis indicated that 11.97% and 7.77% proportion of the effect of BMI on the risk of incident EC is mediated by the TyG index in overweight and obese individuals. High genetic susceptibility could increase the risk of incident EC (HR=1.455; p<0.001), with the relationship between increased TyG index levels.</p>
CONCLUSION: The TyG index demonstrates a significant association with the risk of incident EC and mediates the influence of BMI, thereby implicating insulin resistance as a potential contributor to the pathogenesis of EC.</p>